Here is the text we could read:
IN THE COURT OF COMMON PLEAS OF _________________________ COUNTY
_________________________
ﺔﻌﻃﺎﻘﻤﻟ
ﺔﻣﺎﻌﻟا
ا
ﺔﻤﻜﺤﻤﻟا
ﻻ
ﺑ
ﺘ
ﺪ
ﺋ
ا
ﻴ
ﺔ
ﻓ
ﻲ
_____________________________________________
DEFENDANT / ﻰﻋﺪﻤﻟا
ﻪﻴﻠﻋ
AFFIDAVIT OF SERVICE
ﺔﻤﻜﺤﻤﻟا
قاروأ
ﺔﻴﻄﺧ ﻢﻴﻠﺴﺘﺑ
ةدﺎﻓإ
I, _____________________________, the undersigned,
hereby state that I served a copy of the Notice of Hearing and
Order, Petition and Temporary Order in the above captioned
action upon Defendant by handing the papers to:
________________________________________________
،ﻩﺎﻧدأ ﻊﻗﻮﻤﻟا ،
مﻼﻋإ ﻦﻣ
_____________________________
ﻦﻋ ﺔﺨﺴﻧ
ﻪﻴﻠﻋ ﻰﻋﺪﻤﻟا ﻢﻴﻠﺴﺘﺑ
ﺮﻗأ
عﺎﻤﺘﺳﻻا
ﻩﻼﻋأ ﺔﻧﻮﻨﻌﻤﻟا ىﻮﻋﺪﻟا صﻮﺼﺨﺑ ﺖﻗﺆﻤﻟا ﺮﻣﻷاو سﺎﻤﺘﻟﻻاو ،
،ﺎﻧأ
ﺖﻤﻗ ﻲﻨﻧﺄﺑ ﻪﺒﺟﻮﻤﺑ
ﺮﻣﻷاو
:
ﻰﻟإ
_______________________________________________
ﺪﻴﻟﺎﺑ
at the following address:
:
ﻲﻟﺎﺘﻟا ناﻮﻨﻌﻟا ﻰﻠﻋ
________________________________________________,
،______________________________________________
__________________, Pennsylvania, ON THE ______ DAY
_____________________مﻮﻴﻟا ﻲﻓ ،ﺎﻴﻧﺎﻔﻠﺴﻨﺑ ،_____________
OF _____________________________, 20_____________
____________________
مﺎﻋ ﻦﻣ ،
_______________
ﺮﻬﺷ ﻦﻣ
AT APPROXIMATELY __________ A.M. / P.M.
I verify that the statements made in this Affidavit are true and
correct. I understand that false statements are made subject to
the penalties of 18 Pa.C.S. §4904, relating to unsworn
falsification to authorities.
.
ءﺎﺴﻣ
ً
/
ًﺎﺣﺎﺒﺻ
__________
ﺔﻋﺎﺴﻟا ﻲﻟاﻮﺣ ﻲﻓ
تادﺎﻓﻹا
ﻲﻨﻧإ
.
ﺔﺤﻴﺤﺻو ﺔﻴﻘﻴﻘﺣ ﻲه ﺔﻴﻄﺨﻟا ةدﺎﻓﻹا ﻩﺬه ﻲﻓ
18
ـﻟ ًﺎﻘﺒﻃ تﺎﺑﻮﻘﻋ ﻰﻟإ ﺎﻬﺒﺣﺎﺻ ضﺮﻌﺗ
ﺔﺑذﺎآ تادﺎﻓإ ﻢﻳﺪﻘﺗ
ﻦﻴﻤﻴﺑ ﺔﻋﻮﻔﺸﻣ ﺮﻴﻏ
ءﺎﻄﻋﺈﺑ
ﻖﻠﻌﺘﻤﻟا ،
ﺔﺑذﺎآ تادﺎﻓإ
ةدراﻮﻟا
ﻰﻟإ
نﺄﺑ
نأ
ﺮﻗأ
كردأ
Pa.C.S. §4904
.
تﺎﻄﻠﺴﻟا
No. / ﻢﻗر ________________________________
ROTECTION FROM ABUSE
ﺎ
ﻳ
ﺔ
ﻤﺣ ﻦﻣ ةءﺎﺳإ
P
FAMILY COURT DIVISION
ة
ﺮﺳﻷا
ﻢﺴﻗ ﺔﻤﻜﺤﻣ
CIVIL ACTION
ﺔﻴﻧﺪﻣ
ىﻮﻋد
_____________________________________________
PLAINTIFF / ﻲﻋﺪﻤﻟا
V. / ﺪﺿ
_______________________________________________
Signature / ﻊﻴﻗﻮﺘﻟا
_______________________________________________
Address / ناﻮﻨﻌﻟا
Date / ﺦﻳرﺎﺘﻟا: ____________________________________
HIS FORM MUST BE COMPLETED AND SIGNED BY THE PERSON WHO SERVES THE DEFENDANT WITH
THE NOTICE OF HEARING AND ORDER, PETITION AND TEMPORARY ORDER. IT MUST BE BROUGHT TO
COURT ON THE HEARING DATE.
.ﺐﺠﻳ رﺎﻀﺣإ
ﻷاوﺮﻣ ﻟاﺖﻗﺆﻤ
ﻻاعﺎﻤﺘﺳ ﺮﻣﻷاو ﻻاوسﺎﻤﺘﻟ
ﺔﺴﻠﺠﺑ
مﻼﻋﻹا
ﻪﻴﻠﻋ
ﻰﻋﺪﻤﻟا
مﻮﻘﻳ ﻢﻴﻠﺴﺘﺑ
ﻦﻣ ﻞﺒﻗ ﻟاﺺﺨﺸ يﺬﻟا
ﺳﻻا
ﺘ
ﻤ
ﺎ
ع
ﺔﺴﻠﺟ
.
ﻪﻌﻴﻗﻮﺗو
اﺬه جذﻮﻤﻨﻟا
ﻤﻜﺘﺳا
ﺎ
ل
ﺐﺠﻳ
ﻲﻓ ﺦﻳرﺎﺗ
ﺔﻤﻜﺤﻤﻟا
ﻰﻟإ
ه جذﻮﻤﻨﻟا
ﺬ
ا
_
_
T
ENGLISH/ARABIC PFA Affidavit
Pa. R.C.P. 1905(d) Rev. 11-08
AOPC Rev. 6-2011
Arabic PFA Service Affidavit.doc
This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Pennsylvania state courts.
To learn more about the project, check out our about page.
Downloads: You can download both the original form (last checked 2023-03)
and the machine-processed form with normalized data fields.
About This Form:
- Sourced from www.pacourts.us (2023-03)
- Page(s): 1
- Fields(s): 24
- Average fields per page: 24
- Reading Level: Grade 10
- LIST Grouping(s):
GO-00-00-00-00.
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Identified Data Fields:
We have done our best to automaticly identify and name form fields according to our naming conventions.
When possible, we've used names tied to our question library. See e.g., user1_name.
If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.
Here are the fields we could identify.
ﺔﻌﻃﺎﻘﻤﻟ was ﺔﻌﻃﺎﻘﻤﻟ (0.97 conf)court_common_pleas was in_the_court_of_common_pleas_of (0.42 conf)plaintiff was plaintiff_ﻲﻋﺪﻤﻟا (0.52 conf)no_ﻢﻗر was no_ﻢﻗر (0.45 conf)defendant was defendant_ﻰﻋﺪﻤﻟا (0.47 conf)ﻦﻋ_ﺔﺨﺴﻧ was ﻦﻋ_ﺔﺨﺴﻧ (0.35 conf)i was i (0.38 conf)ﻰﻟإ was ﻰﻟإ (0.35 conf)action_upon_handing was action_upon_defendant_by_handing_the_papers_to (0.49 conf)af_f was AFF009 (0.51 conf)following_address was at_the_following_address (0.37 conf)ﺮﻬﺷ_ﻦﻣ was ﺮﻬﺷ_ﻦﻣ (0.35 conf)page_field__1 was page_0_field_12 (0.31 conf)day was day (0.34 conf)of was of (0.38 conf)page_field__2 was page_0_field_15 (0.31 conf)page_field__3 was page_0_field_16 (0.31 conf)unknown was 20 (0.38 conf)page_field__4 was page_0_field_18 (0.31 conf)مﺎﻋ_ﻦﻣ was مﺎﻋ_ﻦﻣ (0.35 conf)page_field__5 was page_0_field_20 (0.31 conf)ﺔﺑذﺎآ_تادﺎﻓإ was ﺔﺑذﺎآ_تادﺎﻓإ (0.35 conf)date was date_ﺦﻳرﺎﺘﻟا (0.42 conf)page_field__6 was page_0_field_23 (0.31 conf)
We've done our best to group similar variables togther to avoid overwhelming the user.
Suggested Screen 0:
court_common_pleasunknown
Suggested Screen 1:
Suggested Screen 2:
no_ﻢﻗرiaction_upon_handingday
Suggested Screen 3:
Suggested Screen 4:
ﺔﻌﻃﺎﻘﻤﻟﻦﻋ_ﺔﺨﺴﻧﻰﻟإaf_fﺮﻬﺷ_ﻦﻣمﺎﻋ_ﻦﻣﺔﺑذﺎآ_تادﺎﻓإ
Suggested Screen 5:
following_addresspage_field__1ofpage_field__2page_field__3page_field__4page_field__5page_field__6
Suggested Screen 6:
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